Sleep problems also have a snowball effect: A lack of sleep can exacerbate an RA flare, and when you’re feeling fatigued, it’s harder to deal with RA symptoms like joint pain. To add fuel to the fire, sleep problems have been linked to an increased risk of depression, as well as a decreased ability for people with RA to carry out day-to-day tasks.

There are plenty of strategies you can try to help get better sleep. The first step is to work with your doctor to get pain under control. Once you’re on the right RA treatment regimen, experiment with these tips designed to help you fall asleep faster and sleep more soundly:

1. Time your medications. 

In general, taking pain medication near your bedtime can make you more comfortable as you try to fall asleep, according to the Arthritis Foundation. A long-acting anti-inflammatory drug is one option, says Susan Goodman, MD, a rheumatologist at the Hospital for Special Surgery in New York City. Amitriptyline, an antidepressant,  may also be helpful in small doses. And while an evening dose of prednisone helps some people, others say that it keeps them awake at night. Experiment with your medications to see whether a certain time works best for you, says Dr. Goodman. If you feel that your current meds are disrupting your sleep, be sure to talk to your doctor.

2. Warm your hands — with wax. 

This type of heat therapy is a popular way to soothe swollen joints. Many people swear by paraffin wax hand baths, a traditional strategy that may help reduce pain and stiffness, Goodman says. Try giving your hands a warm bath in wax before bedtime.

4. Create a comfortable sleeping environment. 

For most people, the ideal room temperature for sleeping is between 60 and 67 degrees, according to the National Sleep Foundation. Your sleeping space should also be dark and quiet. “If you need a night-light, make it red,” advises Dr. Rosenberg, as “red is the least disruptive type of light when it comes to sleep.” If you can’t keep noise out, consider earplugs, Goodman adds. To maximize comfort, memory-foam pillows and mattresses may be a good option for people who experience chronic fatigue and pain. If your mattress is more than seven years old, or if the warranty has expired, consider replacing it. Regardless of how old your mattress is, though, you might want to ask a friend or family member to help you flip it over approximately every three months to prevent sagging. Lastly, choose soft bedding that doesn’t weigh you down. A heavy blanket can put extra weight and pressure on your joints.

5. Be active during the day. 

Regular exercise isn’t just critical for your health — it’s also important for getting restorative sleep at night. Physical activity can increase sleep quality and decrease pain perception for people with RA, according to research published in November 2015 in the journal Joint Bone Spine. Just don’t exercise too close to bedtime or too late at night, Dr. Zashin says, as being active can have energizing effects.

6. Watch what and when you eat. 

Avoid caffeine in the afternoon and evening, as it can keep you awake at night. And don’t eat too late or, when it’s getting close to bedtime, too much — a full stomach can keep you tossing and turning. Also, skip the nightcap — alcohol may help you fall asleep, but it can actually interfere with sleep quality.

7. Establish a regular bedtime. 

Try to go to bed and wake up at the same times every day — even on the weekends. This will help program your body’s internal clock, Rosenberg says, allowing you to sleep better at night. When you’re trying to fall asleep at night, if you can’t sleep after about 20 minutes, go to another room. Read a book or listen to soft music until you’re sleepy enough to get back under the covers and fall asleep.

8. Keep pets out. 

Though you might like to cuddle up and snooze with your dog or cat, pets tend to disturb your sleep. Rosenberg recommends that if they are going to sleep in your bedroom, they lie in their own beds.

9. Choose a scent. 

Using aromatherapy as bedtime approaches may help you sleep better at night, Rosenberg says. Consider trying essential oils like lavender, valerian, or bergamot. Some people also say that white noise machines help them nod off.

What to Do If You Still Can’t Sleep

Getting a good night’s sleep is crucial for people with RA, and it might take some trial and error to find the best sleep routine to get you the shut-eye you need. If these strategies don’t help you get better sleep, you may be able to make some other adjustments during the daytime, such as:

Making changes  at work to conserve energyTaking a power nap to rechargeDelegating tasks as needed to avoid overburdening yourself

If all else fails and you’re still not sleeping at night, be sure to talk to your doctor, who can adjust your treatment to try to help, or have you evaluated for any potential underlying sleep disorders.